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Welcome to the website that tells you all about
the NHS in Wiltshire
NICE
Wiltshire Primary Care Trust (PCT) is the driver of a continuously improving National Health Service (NHS) in Wiltshire. We seek innovation, knowledge and best practice.
What is NICE
The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health.
What does NICE do?
NICE produces four types of guidance:
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Technology Appraisal |
Recommendations on the use of new and existing medicines and treatments in the NHS. |
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Clinical Guideline |
Recommendations on the appropriate treatment and care of people with specific diseases and conditions in the NHS. They are developed by groups of clinical and patient experts. |
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Public Health Guidance |
There are two types of guidance on public health: - Public health intervention guidance makes recommendations on clear activities (interventions) to promote a healthy lifestyle or reduce the risk of developing a disease or condition; - Public health programme guidance – deals with broader activities for promoting good health and preventing ill health. |
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Interventional Procedure |
An interventional procedure is used for diagnosis or for treatment that involves: - making a cut or hole to gain access to the inside of a patient’s body; - gaining access to a body cavity without cutting into the body (eg endoscopies); - Using electromagnetic radiation (eg X-rays and laser treatments). NICE interventional procedures guidance covers: - the safety of the procedure - advice on whether it works well enough for routine use; - advice on whether special arrangements are need for patient consent. |
While drug recommendations tend to deal with just one aspect of a patient’s pathway through the NHS, these clinical guidelines set out how patients with a particular condition should be treated through their healthcare journey. They are therefore a powerful tool to improve the patient experience and ultimate outcome. They also lead to more efficient use of NHS resources by ensuring that inappropriate management is reduced to a minimum.
How clinical guidance are developed
NICE guidance is developed using the expertise of the NHS and the wider healthcare community, including NHS staff, healthcare professionals, patients and carers, industry and the academic world. NICE advertises for people to sit on the independent guidelines development groups.
NICE Patient & Public Involvement
The final version of the clinical guideline is published by NICE in a variety of forms suitable for different audiences, including plain English versions aimed at the public. The Institute can also respond within few minutes for most languages
About the implementation of Clinical Guidance
There is no `must do` date, such as exists for drug appraisals. Implementation may also not be set in stone. NICE states: “NICE guidance does not replace the knowledge and skills of individual health professionals who treat patients”.
Clinical Guidelines can take some time to be fully implemented – perhaps two to three years, even with local support and funding. New patient pathways may need to be developed to cross both primary and secondary care, and new services may need to be developed.
Finance
When the Audit Commission looked at the issue of money, it concluded that the problem of the cost of implementing NICE guidance was related to the need for systematic financial planning, rather than for the money itself. NICE now provides a forward planner to give early warning of new guidance which may have financial implications.
What does WPCT do to implement NICE
The Care Quality Commission checks up on the NHS and independent (i.e. private and voluntary) healthcare sector in England annually. They make sure that healthcare organisations are meeting Government standards of care.
Under the Care Quality Commission’s assessment process NHS organisations are required to publish an annual declaration of whether they meet core standards and of progress towards developmental standards. The implementation of NICE guidance is the main feature of three out of twenty-four core standards. Consequently, NHS organisations need robust mechanisms to monitor implementation to make an informed declaration.
Read more about the Care Quality Commission Annual Health Check here.
Since the merge of the three Primary Care Trusts in October 2006 (South Wiltshire, Kennet and North, and West Wiltshire) significant progress has been made towards NICE implementation in Wiltshire.
Wiltshire Primary Care Trust has strong leadership and strategic arrangements in place to ensure the swift implementation and tight monitoring of NICE guidance. We are working closely with our provider services, independent contractors and are strengthening communication with our three main acute trusts, Salisbury Foundation Trust, Royal United Hospital Bath and Swindon and Marlborough NHS Trust, and the Avon and Wiltshire Mental Health Partnership Trust.
Growing GP Support
WPCT is working closely with GP practices to ensure that they follow national guidance and that this is embedded in their clinical practice. PCT facilitators meet representatives from each general practice on a regular basis to review their practice in line with national guidance.
We are currently reviewing practice regarding Obesity and Heavy Menstrual Bleeding. Guidance on Feverish Illness in Children and Urinary Tract Infection has been implemented and will be audited later this year.
A group has been established for implementation of the Urinary Incontinence guidance, to ensure that the same quality care is provided across all areas of Wiltshire. A clinical audit is being carried out to review current practice in comparison to the guidance recommendations. Results of a patient satisfaction survey are also being considered.
NICE Implementation Policy – lay version
A NICE Implementation Policy and Process have been developed and ratified which all clinicians must follow. You may download the plain English version of this policy here.
Reference: HSJ Supplement / 6 December 2007; NICE Guidance
www.nice.org.uk
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